The broad objective of this research is to evaluate the relative efficacy of pharmacotherapy and psychotherapy, alone and in combination, for the treatment of acutely depressed nonpsychotic, nonbipolar, outpatients diagnosed as having a primary major depressive disorder by RDC criteria. Specifically, this treatment assessment research project will compare the relative efficacy of imipramine, cognitive-behavior therapy, and imipramine plus cognitive-behavior therapy. In order to draw valid conclusions about the "active" ingredients in these therapies, a placebo control will be included for the imipramine condition and a cognitive-behavior therapy plus placebo control will be included for the cognitive-behavior therapy plus imipramine condition. The acute phase of treatment will last 3-4 months, followed by an evaluation follow-up phase of 8-9 months. Psychotherapy will be given in a group format and outcome ratings will be obtained from therapists, patients, and "significant" others. The study will provide a construct replication of the Rush, et al (1977), study which reported a therapeutic advantage for cognitive-behavior therapy compared with imipramine in the treatment of depressed outpatients diagnosed by Feighner criteria as primary affective disorder, unipolar type. Additionally, this study should indicate whether or not the addition of imipramine to cognitive-behavior therapy is of specific, i.e., pharmacologic, benefit for the treatment of primary depressive disorders.